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ÕD²µ MßDhûo

OSTEOMALACIA (in Urdu)

INFORMATION SHEET

éaFDOÆ íNDÖàÏ·Ö

n U r d u ) INFORMATION SHEET éaFDOÆ íNDÖàÏ·Ö Osteomalacia Osteomalacia, meaning soft bones, is

Osteomalacia

Osteomalacia, meaning soft bones, is a con- dition which affects the skeleton. The bones may bend, particularly in children, and can also break easily. It is often, but not always, caused by lack of vitamin D. In this country, people of South Asian origin are often affected by osteomalacia.

For healthy bones the body needs calcium, phos- phorus and vitamin D. If the body does not have enough of any one of these, osteomalacia will develop. Calcium and phosphorous deficiency are rare. The most common cause of osteomalacia is a lack of vitamin D.

VITAMIN D

The body can make its own vitamin D. When sunlight falls on the skin cholesterol in the skin is turned into vitamin D. Vitamin D helps calcium and phosphorous to be absorbed and incorporated into the bones. During the summer, the skin produces enough vitamin D for the body to build up a store for the winter.

Your diet can also provide vitamin D. Oily fish such as mackerel, herring and kippers are good sources – one portion each week is probably sufficient. Eggs, dairy products and margarine also contain vitamin D. Some foods, such as breakfast cereals, have vitamin D added. Most foods, however, contain very little vitamin D.

Certain groups of people, who get less exposure to sunlight, are at risk from vitamin D deficiency. Elderly people, people who are too ill to go out, and people who cover their skin for religious purposes (for example, with the burka) may not make enough vitamin D in their skin, and will need to make sure that they get enough from their diet or take supplements.

WHY ARE PEOPLE OF SOUTH ASIAN BACKGROUND MORE AT RISK?

There are two main reasons for this:

Sunlight Dark skin is protective in parts of the world

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where the sun is intense. In areas where there is

less daily sunlight (such as the UK) dark skin may be ‘overprotective’ and the skin may produce less vitamin D. Traditional dress, such as the burka, will also reduce the ability of your skin

to produce vitamin D, because it stops sunlight falling on the skin.

Diet Diet is particularly important for people who do not produce enough vitamin D in the skin. Vegans (who don’t eat meat, fish or dairy prod- ucts) are most at risk, as they get very little vit- amin D or calcium. But you can also be at risk if you are on a lacto-vegetarian diet (you eat dairy products but not meat or fish). This provides calcium but may not contain enough vitamin D, which is needed to absorb the calcium. Chapatti flour may also reduce the absorption of calcium from the stomach.

WHAT ARE THE SYMPTOMS OF OSTEOMALACIA?

Osteomalacia causes bone pain and muscle weakness, but symptoms are so vague that they may be put down to ‘rheumatics’ or ‘fibrositis’. It is common for people to suffer from osteomalacia for 2–3 years before it is diagnosed.

The pain does not normally affect any one part

of the body, but is most often felt in the legs, the

groin, upper thighs, and knees, and sometimes

in the feet when you stand, walk or run. Sitting

or lying down relieves the pain. Backache is common, and sometimes a minor knock is unnaturally painful.

Some of the pain is caused by slight cracks in the bone (partial fractures), which are visible on x-rays. Occasionally the cracks can lead to complete breaks (complete fractures), but these will heal once treatment begins.

Muscle weakness tends to affect the thighs and

the shoulders making it difficult to climb stairs or get out of a chair. Sometimes people walk with a waddle, rocking from side to side. If your illness

is very severe you may not be able to get out of bed.

HOW IS IT DIAGNOSED?

A simple blood test is all that is needed – the

levels of calcium, phosphorus and vitamin D are

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easily measured. An x-ray may show the typical partial fractures. Your doctor will take particular note of your diet and any tablets you are taking, and any family history of bone disorders.

HOW IS IT TREATED?

Treatment will usually cure osteomalacia, although it may take several months for symptoms to improve. Daily treatment with vitamin D tablets is all that is needed. Alternatively, some doctors may give an injection once a year. Calcium supplements are also advised, particularly if the diet is poor in calcium and phosphate. Foods rich in calcium are dairy products, bread and some fish, particularly those where the bones are included such as tinned sardines. Vitamin D supplements will be required over a long period to prevent the osteomalacia coming back.

RARER CAUSES OF OSTEOMALACIA

Although lack of vitamin D is the most common cause of osteomalacia your doctor will need to check for rarer causes such as liver disease, kidney failure and coeliac disease. Some cases of osteomalacia are due to inherited abnormalities in the metabolism of calcium and phosphorous. Osteomalacia can also be caused by tablets for epilepsy, or it can sometimes happen after stomach surgery.

These other causes are generally detected by blood tests and x-rays, similar to those described above.

People with the rarer causes of osteomalacia often need lifelong supervision from their doctor. People with kidney failure or inherited forms of osteomalacia usually need special forms of vitamin D (calcitriol), which is normally produced by the kidney. They will need to be monitored regularly in hospital.

WHAT CAN I DO TO HELP MYSELF?

Look carefully at your diet, or ask to see a dietitian. Foods high in vitamin D and calcium are mentioned above. You may need to take supplements, particularly if you are elderly, preg- nant or breastfeeding, or if you wear traditional dress that covers much of the skin. Some chapatti flours now have added vitamin D – check the packaging for this information.

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ÕD²µ MßDhûo

OSTEOMALACIA (in Urdu)

SUMMARY

Osteomalacia often happens because of a lack of vitamin D. It causes severe bone pain and muscle weakness. In most cases, after treatment with vitamin D, the osteomalacia is cured and symptoms will disappear. Even the rarer causes can be successfully treated with long-term treatment.

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The Arthritis Research Campaign funds research into all forms of arthritis, and publishes a range of booklets and leaflets. Please contact arc or see the website www.arc.org.uk for details of the titles available.

The information in this leaflet is also available on a multilingual audio CD.

this leaflet is also available on a multilingual audio CD. DNpÆ ØçCp3⁄4 éëDÖpv}òÏìÆÄìÃeN

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